Active NPI
Farah N Khan, DDS
- Pediatric Dentistry
- Canton, MI
National Provider Identifier
1548369291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 547431
- Practice address
- 45535 Hanford
Canton, MI 48187 - Phone
- (734) 254-0786
- Fax
- (734) 254-0861
- NPI assigned
- Sep 21, 2006
- Last updated
- Jun 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 543728 | MI | |
| Pediatric Dentistry | 1223P0221X | 547431 | MI | Primary |
Addresses
Primary practice location
45535 Hanford
Canton, MI 48187
Mailing address
45535 Hanford
Canton, MI 48187
Phone (734) 254-0786
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4755112 | Medicaid | MI | |
| 1698319 | Other | UNITED CONCORDIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 543728 | MI | MD | General Practice Dentistry |
| 547431 | MI | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Dentistry | General Practice | Current | Accepting new patients |
Locations
45535 Hanford Rd
Canton, MI 48187
Phone (734) 254-0786
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560729600000",
"number": "1548369291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45535 HANFORD",
"city": "CANTON",
"state": "MI",
"postal_code": "48187",
"telephone_number": "734-254-0786",
"fax_number": "734-254-0861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45535 HANFORD",
"city": "CANTON",
"state": "MI",
"postal_code": "48187",
"telephone_number": "734-254-0786",
"fax_number": "734-254-0861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "FARAH",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2019-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "543728",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MI",
"license": "547431",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4755112",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "1698319",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.